Crohn's Disease Forum » Treatment » Remicade/Infliximab » Does a Remicade infusion really cost THAT much?


 
04-06-2011, 09:23 AM   #1
Sha0913
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Does a Remicade infusion really cost THAT much?

I live in new Jersey and get my Remicade and all procedures (anything medical) done at the hospital of the University of Pennsylvania, the best place to be treated in the world to me(just opinion, I can call or email my doctor and they will almost always respond within minutes, no matter how big the situatuation). I have great insurance that covers 100% because I am a state employee working in the New Jersey School system. So i cant complain about my insurance or my hospital but I do get the statements from the hospital for my records and for my infusion every 6 weeks the cost on the statement says $16,000. Seriously?!?!?!
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04-06-2011, 09:38 AM   #2
Crohn's 35
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Yes!!! Here in Canada it is $4,100.00 per infusion, and I believe your intial doses are close together (been almost 3 years since I have had Remi) and our clinic is covered by the govt. Thank God I have 100% coverage too. The main point is,if it works for you, the price is worth it. Let us know how you are doing on it!
04-06-2011, 11:41 AM   #3
Starla86
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After insurance my portion is 1200 for the first infusion and 600 for each after that. Luckily I got on Remistart and they pay 4100 a year towards infusions which covers most of my costs. I wish I had your insurance, mine basically laughed at me when I my dr tried to get my colonoscopy covered because Im only 24. They told her it was an un nessesary treatment for anyone under 50 for any reason HAHAHA is all I had to say about that. Whatever you do dont loose that insurance
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04-06-2011, 07:59 PM   #4
Lydia
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My treatments cost 3300 for meds, and I dont know how much the clinic costs because its covered by public healthcare.
04-07-2011, 06:31 AM   #5
sabin
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I Donīt pay anything itīs completely free for us here since its regarded a necessary treatment.

Itīs alot better than in the U.S i feel sorry for you guys having to pay to be relieved of suffering.


But i did ask my dr about the price for Remicade he said it costs about 20-30 000 € per patient per year.
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04-07-2011, 06:58 AM   #6
Sha0913
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Im not exactly sure how much the Remicade itself costs, but when I get the statement it has $16,654 as the total for the hospital bed for the 2 hour infusion, the med and for the nurse in the unit where I get the infusion. So all in all every 6 weeks my insurance pays over $16,000, thats 144,000 a year just for the remicade insusion, not including Drs appts, Iron Infusions, and blah blah blah, thank God I have state insurance that covers 100%, I feel for everyone out there that has to fight to pay or get help to pay for their meds.
04-07-2011, 07:23 AM   #7
sabin
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Im not exactly sure how much the Remicade itself costs, but when I get the statement it has $16,654 as the total for the hospital bed for the 2 hour infusion, the med and for the nurse in the unit where I get the infusion. So all in all every 6 weeks my insurance pays over $16,000, thats 144,000 a year just for the remicade insusion, not including Drs appts, Iron Infusions, and blah blah blah, thank God I have state insurance that covers 100%, I feel for everyone out there that has to fight to pay or get help to pay for their meds.
It seems to be an extremly high amount in comparison to what my Dr told me!!

Last edited by sabin; 04-07-2011 at 08:25 AM.
04-07-2011, 08:14 AM   #8
Cookie
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I agree. My insurance covered my Remicade infusions 100%, but I remember it being somewhere around $4300/ infusion.
04-07-2011, 08:40 AM   #9
Sha0913
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Im pretty sure the Remicade runs about $4500 but the rest of the cost are the hospitals outrageous costs. Which includes the bed fee, the Iv fee, the Iv site fee and so forth and so on. I'm at work now but I'm going to grab a statement and I will put the breakdown on here tommorow.
04-07-2011, 03:16 PM   #10
moogie
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I just went through the cost myself because I'm getting my frist infusion tomorrow.

4000 per infusion that's just for the medication. The clinic is free.

Of that I am covered 80% with my insurance. That means I have 800$ left to pay. However in Canada when yuo reach the maximum 963$ per year the rest of your medication is free. I'm lucky I have a second insurance that covers 80% of the remaining 800 which means that I pay pretty much 200$ a year for my remicade. I could never afford 4000$ a shot. I do feel for people with no inssurance.
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04-07-2011, 04:12 PM   #11
slightlysilly
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I have a $2500 deductible per year on my insurance but after that everything else (drugs, procedures, hospital, etc.) is 100% free. My last statement for remicade put it at $4,000 and that included the infusion, nurses, etc.

I just found out that a 30 day supply of Entocort is $1,000.00. Whoa! I'm just glad to be able to afford really good insurance. We are a small business so we have to pay for the insurance through the business. I can't imagine what things would be like if I had to do an 80/20 copay situation.

Cheers!
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04-07-2011, 04:46 PM   #12
Trev
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wow i love our national health system in new zealand, i had two remicade infusions that were free, i was told they would have cost $6000 each, which i would have spewed about if i had to pay, as they didnt work. i pay $40 for doctors visits, GI is free. $3 per script at the chemist and after 20 they are free. i feel sorry for you guys fighting insurance companies just to get your health sorted, and even more for those with no insurance. if i try a drug and it doesnt work, or i cant tolerate it, i throw them out because no one wants them and i cant return them, what a waste, when there are people inother countries strugling to afford them.
04-08-2011, 01:59 AM   #13
sabin
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It truly disgusts me when i hear that people has to pay for something like this.

All governments should see that this is a necessity for us to even feel remotely normal and all treatments should be completely free for the chronically ill.

What they should do is to put real pressure on the Drug companies to actually heal us so that we can function better and cost less for the healthcare systems and that way they would be able to earn more money on us from taxes since we would be able to work a lot more.

All we get is disease management curing never seems to be on the table even though we hear about breakthroughs in medical science all the time.

For example i saw a program where scientists managed to make new bodyparts that had 0% chance to be rejected. They basically took the same organ from a dead body washed away everything from it and what remains is a very thin membrane that holds all the bloodveins and from this they have crated functioning hearts lungs and so on with stemcells and a woman in spain even have had one of these "parts" operated in to her and it works perfectly.

Why wouldnt this work on the intestions for example if someone needs to operate they can replace the whole intestion at once and than maybe the chance to get a flare again would be minimal. Or the need for a "bag" on the stomach would disappear forever.

Im just saying they should stop with this management of the disease what we need is people who thinks outside of the box and comes up with a cure.
04-08-2011, 06:36 AM   #14
Astra
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That's why I love our NHS!
I asked how much for Infliximab and they said about Ģ2000 per infusion.
But it's free over here.
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04-08-2011, 10:29 AM   #15
Becky
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On my EOB the drug typically cost about $6000. Luckily I only have to pay a $40 copay.
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04-08-2011, 11:30 AM   #16
slightlysilly
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I guess the question is, what makes Remicade so expensive? Is it hard to find? Hard to mix? Hard to administer? What's the deal with that?

I don't know about anyone else, but I get Remicade literature from the pharmecutical company almost EVERY DAY. Big thick packets with nice pictures of people dancing around and talking about Remicade... sometimes there's a DVD or CD in there. I mean...that's a huge waste especially since I'm not the one who came up with the brilliant idea of going on Remicade. It was my doctor's idea.

Just sayin..
04-11-2011, 03:06 AM   #17
sabin
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@Slightlysilly

I see that you take Predisone & Remicade at the same time, how do you feel?

I was thinking about asking my Dr about that since i feel good for about 10 Days after my Remicade infusions but after that the pains start up pretty fast again.
I was thinking about getting prednisone as a Remicade "helper" so to speak.

Or does this with the pains get better with time? Im having my third Remicade Infusion on the 22nd this month btw.
04-11-2011, 02:55 PM   #18
Lydia
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Biologic therapies are really hard to make. It takes a lot of man hours with not a lot of end products. This is why they are so expensive. I used to work in a plant that made a biologic therapy for macular degeneration. Its a lot of work.
04-11-2011, 03:04 PM   #19
aliciars
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I am in debt from this disease...so not fun. My insurance is trying to refuse paying for my last MRI. UGH. Stress is the best thing for Crohn's right?

I luckily am part of the Humira assistance program and only pay $5 a month for that. Humira's roughly $800 a shot, and I do 4 a month....insane.

All of your responses with gov't run health coverage sounds great.
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04-11-2011, 04:08 PM   #20
slightlysilly
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@Sabin - I feel just ok. I'm of the belief that my ilium is ruined and is just probably causing me all of this pain. Currently, my GI is trying EVERYTHING before we go to surgery. Remicade has not helped me as of yet, but I've only been on it since December. The prednisone helped at first but then I had trouble tapering down (I invite you to my blog which is listed below) It explains my troubles with prednisone without going into too much detail. But like I said, it really worked at first, but the doctor only had me on it at 40mg for a week, and then my troubles began...

@Lydia - Interesting. So it really takes that much man power to make Remicade? What kind of people make remicade? Are they chemists? I really am interested in the process. I guess since there is such a discrepancy between the cost of the medication and the ability for most people to buy the medication (imagine if we all had to walk into a pharmacy and purchase Remicade for $4,000.00 per bag) I wonder if the price would be lower if insurance companies stopped paying. Then there's the whole national healthcare system that some of us have, and they pay the same amount. I guess when someone gets diagnosed with a chronic disease (such as Crohn's) you (or I) start to really pay attention to what drugs and procedures cost and then wonder how anyone without insurance or NHS can afford treatment.
04-11-2011, 05:04 PM   #21
Misty-Eyed
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That's why I love our NHS!
I asked how much for Infliximab and they said about Ģ2000 per infusion.
But it's free over here.
It's come down a lot in the past 10 years. It was Ģ16,000 per infusion then. Crazy money!

Every time my co-worker complains about how much tax we pay, I tell him it covers my medical expenses and he shuts up lol
04-11-2011, 05:11 PM   #22
Lydia
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.

@Lydia - Interesting. So it really takes that much man power to make Remicade? What kind of people make remicade? Are they chemists? I really am interested in the process. I guess since there is such a discrepancy between the cost of the medication and the ability for most people to buy the medication (imagine if we all had to walk into a pharmacy and purchase Remicade for $4,000.00 per bag) I wonder if the price would be lower if insurance companies stopped paying. Then there's the whole national healthcare system that some of us have, and they pay the same amount. I guess when someone gets diagnosed with a chronic disease (such as Crohn's) you (or I) start to really pay attention to what drugs and procedures cost and then wonder how anyone without insurance or NHS can afford treatment.
Well it would take about a week from beginning to end. I did quality control, and if anything went wrong they would have to scrap the batch and start all over again. When the process was over there was maybe 1-2 kg of finished drug. The plant ran 24/7. The process is over seen by a phd, but chemists do all the grunt work. Critical steps have to be monitored by QC, and signed off by the supervisor(phd). Starting materials are very expenisive because purity is a must. Its not like other drugs, where there is 1-2 tons of product at the end of processing. Different biologics have different recipes so I cant really tell you how they make remicade except a very general description.
04-11-2011, 10:10 PM   #23
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I am a British citizen living in the USA, life was great until my husband and my son both deeloped autoimmune disorders. Lee husband is on a different insurance to Brandon (son). Brandonds deductable is $7000 a year, Lee's is $2500. the premiums for the entire family (4) per month come to $425. When Brandon , Toby (other son) and I reach $7000 in a calendar year everything covered by the policy is covered 100% My husband is on 80% coverage until $10,000 out of pocket. In 2007 Lee was bitten by a blackwidow spider mowing the lawn. He was in hospital for 11 days, ended up with a staph infection, which triggered a so far undiagnosed autoimmune disease causing low platelets and white blood cells. Lee had surgery and had a bill for $49,000 of which we owed $19,000 it turns out the hospital was in the insurance network but the surgeon wasn't and out of network out of pocket is doubele $20000. We are still paying that bill. Same year Brandon had first diagnosis of crohns, after colonospcopy and a day in hospital we met his out of pocket $7000. So total medical expenses in 2007 were $31,000 approximately 40% of our income. Lucky for us we had a couple of credit cards!! We are still apying. Then this year Brandon had repeat colonoscopy and we hit the $7,000 deductable by the end of January. The hospital was slow to file insurance, so when they put us on Entocort at $1200/month, the insurance considers it a tier 3 drug and only pays $100 a month, we had to credit card it again, pharmacy's don't do payment plans like hospitals so we had to put out two months worth before the hospital filed the insurance. I don't think we will ever get out of debt and now Friday last week both Brandon's Doc and Lee's Doc independently recommended Remicade for Brandon and Rituximab (very similar drug) for Lee. Bothdrugs are highly expensive, and we are waiting to see if either insurance company covers them.
We are seriously thinking about moving back to the UK. If Lee gets so he can't work we won't be able to afford to pay the mortgage and the medical bills. I hear people here can die from a lack of insurance to pay for meds in diseases like Hepititis and HIV because they don't have insurance.
I am disgusted health insurance companies can be allowed to make a profit out of peoples sickness, and I wholeheartedly support a National Health System.
The propaganda of having to wait and not being able to get the drugs you need on a national health system is untrue. Just so you know in both Canada and the UK the $1200 a month entocort sells through the private healthcare network for $200 a month!!

OK venting over.

Have you seen the facebook page Entocort the road to poverty?? Anyway its not working so now it will be Remicade and Rituximab the road to poverty!

Vent over!!
05-07-2011, 09:51 PM   #24
STLGirl
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Well, I got my first two bills for infusion one and two and they were $4000.00 for each (medicine only) then added expenses for infusion proceedure. I asked the girl at Remi Start if that was the standard cost and she said yes. I can see from your comments above, that yes, it's the standard cost. So what the hell.........how can one drug cost so darn much !!
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05-13-2011, 03:10 PM   #25
glum chump
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With respect to the high cost associated with the biologics: part of the issue is that the makers of Remicade holds the patent over Remicade, and so a generic version can't be produced. The introduction of generic drugs really pushes the price of drugs down. The company that owns Remicade's patent will hold it for at least 12 years (although there's plenty of ways that pharmaceutical companies try to extend the clock).

The argument is that drug companies that hold the patent have put a lot of resources into research and development and therefore need to recoup the costs of R&D, as well as marketing costs. While it is estimated that these costs can run up to 800 million dollars (for more innovative drugs---most companies incur costs of about 100-200 million), a lot of pharmaceutical companies are doing the majority of their testing in (former) Eastern European and developing countries to minimize their research costs.

I was on a drug trial for Ustekinumab and it worked for me, but I was not able to get any more of the drug after the study ended. For me to pay out of pocket would have been over $10,000 out of pocket every three months. A business report that I read forecasts that if Ustekinumab is approved for people with Crohn's (it has a ways to go--Phase 3 hasn't yet started), the drug will earn the company over 6 billion dollars IN ONE YEAR. I think they will be able to recover ALL their costs within 12+ years.

Back in 2008-09, the amount of money made through the sale of Remicade was 5.2 billion dollars. I don't know what their recent sales are. For 12+ years, they have the monopoly over the drug so they're able to set the price.

Don't know if my post just confuses or muddies things up---if it does, my apologies!

Kismet
05-14-2011, 07:54 AM   #26
Saphira
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Great post Kismet,
I was shocked at the cost of some of the drugs. We were on Entocort for a while and the drug was $1200 a month, our insurance only paid $100, we had to pick up the other $1100. Good job I had a credit card! I wonder how many people go without the drugs they need because they can't afford it.
Should it really be a privilege to receive a medication that works?

I am biased because I lived in the UK for 23 years and experienced universal healthcare where this didn't happen.
Trina
05-19-2011, 09:41 PM   #27
davidr
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A single Remicade infusion here in Japan costs 320,000 yen, or about $4000, just for the Remicade itself and then another $300 for lab work and the IV. Insurance only pays for 70% but luckily there is an income-based assistance program for people with chronic illnesses that covers most of the remainder (and 100% of all prescription drugs!). All in all, my out-of-pocket expense is about $15 per infusion. Even though I'm a long way from home, it's nice to I live in a country where my ability to be treated does not depend on my employment!
09-13-2011, 06:59 PM   #28
Mazer10
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What are the programs for financial assistance? What are the best ways to get remicade and keep costs low? THANKS

- California
09-13-2011, 08:26 PM   #29
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Mazer, look into remistart. I wouldn't have been able to stay on remicade without it! Remistart is a rebate program for people with med. insurance but with huge deductibles and minimum payments. It saved my life!
09-15-2011, 09:15 PM   #30
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Yep loving our NHS.I joke to my dad that im helping him get his tax back everytime I have an infusion.
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Crohn's Disease Forum » Treatment » Remicade/Infliximab » Does a Remicade infusion really cost THAT much?
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